Prospective open registry of treatment results

This completely anonymous registry is based on your mail-address and numbers (1, 2, 3) etc. you give your treated patients to avoid any possibility to find a correlation to real persons. With your participation you help us to find out, if this approach is effective or not.
Please provide the data 1 week after treatment, the system would send a mail after 3 months and 1 year to ask you to provides us with the current pain level of your patient, if available.
You will find further information at www.venenpraxis-wunstorf.de/studie
Thank you so much, Erika Mendoza

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* 1. Please provide us with your Study center number (if you do not have any, please contact erika.mendoza@t-online.de to receive one)

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* 2. Please provide us with your mail address to allow a follow-up question

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* 3. Number of the patient (please start with 1, then 2, etc. for every further patient you include)

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* 4. Age of the patient

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* 5. BMI of the patient

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* 6. The patient has a lipedema at (more than 1 possible)

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* 7. The patient wears compression regularly?

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* 8. Main pain score before the treatment (0-10) at the right arm (if applicable)

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* 9. Main pain score before the treatment (0-10) at the left arm (if applicable)

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* 10. Main pain score before the treatment (0-10) at the right leg (if applicable)

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* 11. Main pain score before the treatment (0-10) at the left leg (if applicable)

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* 12. Which local anesthesia did you use?

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* 13. How many ml did you apply to the right arm?

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* 14. How many ml did you apply to the left arm?

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* 15. How many ml did you apply to the right leg?

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* 16. How many ml did you apply to the left leg?

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* 17. Main pain score 1 week after the treatment (0-10) at the right arm (if applicable)

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* 18. Main pain score 1 week after the treatment (0-10) at the left arm (if applicable)

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* 19. Main pain score 1 week after the treatment (0-10) at the right leg (if applicable)

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* 20. Main pain score 1 week after the treatment (0-10) at the left leg (if applicable)

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* 21. Do you allow us to send you follow-up Question about the pain score of this patient?

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